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For patients who are at greater risk for
NSAID-associated toxicity or exhibit OA symptoms, albeit NSAID regular use,
data on the long period use of these medicines is obligatory.
The first-ever underway trial work on the consequences arise following the withdrawing of (Nonsteroidal anti-inflammatory drugs) NSAIDs in knee OA patients, which on successful completion will provide significant data contrary the NSAIDs continual use in such patients. Osteoarthritis (OA) is a most common cause of knee pain and disability of lower extremity in older adults. Quality of life of the knee OA patients has significantly decreased in all domains compared to age-matched controls. Veterans have the higher prevalence of OA compared to non-veterans because of injuries during training and active duty. Veterans develop OA at a younger age than civilians. Therefore, it is essential to establish safe approaches to manage pain in this younger population suffered from OA.
NSAIDs fits perfectly into this situation.
Various data from short-term studies also govern the efficacy of NSAIDs over
placebo and acetaminophen. However, no long-term data is present till date. Moreover, the decrease in pain conferred by NSAIDs does not meet
patient-defined thresholds indicating clinically significant improvement. In
this research, Goulet JL et al describe the design and rationale of a withdrawal trial to
examine discontinuation of an NSAID for painful knee OA.
In this study, the author included the veterans
participants with knee OA. The patients were enrolled in the VA Healthcare
System with knee OA pain despite NSAID use and relatively higher risk of NSAID
toxicity. The included patients will replace their current NSAID with the
meloxicam (study NSAID) after the two-week run-in period. Those who remain
eligible after two-week period will then enter into the four-week study where
they will randomized to continued meloxicam use versus placebo for four weeks.
Knee pain after four weeks post randomizations was assessed as a primary
outcome. Secondary outcomes include lower extremity disability, global
impression of change, adherence to study medication and use of co-therapies.
Contemp Clin Trials. 2018 Feb;65:1-7.
Discontinuing a non-steroidal anti-inflammatory drug (NSAID) in patients with knee osteoarthritis: Design and protocol of a placebo-controlled, noninferiority, randomized withdrawal trial
Goulet JL et al.
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